Obamacare enrollments far below targets

CaptionHouse Dems break with the White House on Obamacare vote

CaptionSen. Ted Cruz Wants Obamacare Repealed

Lisa Mascaro, Noam N. Levey and Michael A. Memoli

WASHINGTON — Newly released figures show enrollments for coverage under President Obama's healthcare plan fell far below official projections, underscoring the damage inflicted by the botched rollout and further endangering the administration's support among restive Democrats on Capitol Hill.

Just 106,185 Americans successfully enrolled in health coverage in October. The administration had hoped to get half a million people signed up in Obamacare's first month. About a third of the enrollments — 35,364 — came from California.

To head off a revolt among lawmakers, White House officials said Wednesday they would have a plan soon — perhaps by Thursday — to help millions of Americans whose current health plans are being canceled because they don't meet the law's standards.

Administration officials also sought to reassure doubters that the online marketplaces created by the law would be viable, emphasizing strong consumer interest in shopping for health insurance through the Affordable Care Act.

Nationwide, nearly 1.1 million people have been approved to get insurance through one of the new marketplaces but have not yet chosen a plan, the Department of Health and Human Services reported. An additional 396,000 have qualified for Medicaid and the Children's Health Insurance Program.

The Obama administration hopes to enroll 7 million people in new state-based marketplaces by the March 31 deadline.

But whether the administration can hold nervous Democrats in line much longer is unclear.

Anxious congressional Democrats have become increasingly panicked by the problematic debut of the president's signature domestic policy achievement as they head into the 2014 election.

Rep. Raul M. Grijalva (D-Ariz.), a leader of the progressive wing in the House, called the enrollment numbers "disappointing."

"What it shakes my confidence in is the ability to pull it off, which is essential to this whole thing," he said. "I can go out and debate the substance of this with anybody. I can't defend or debate the programming, or our inability to make this thing work the way it was promised it would work."

Democratic worries have been galvanized by the insurance policy cancellations, which conflict with a promise Obama repeatedly made that people would be able to keep plans they liked.

Republicans have promised to make Obamacare a defining issue in next year's campaigns.

House Republicans will press forward Friday with a vote that will be tough for many Democrats to oppose. The bill from Rep. Fred Upton (R-Mich.) would allow insurance companies to continue to offer policies on the individual market that don't meet new standards set by the Affordable Care Act.

Democratic uneasiness was underscored when Rep. Carol Shea-Porter of New Hampshire announced her support for the bill. The Democrat lost her reelection bid in 2010 after voting for the healthcare law, but won again in 2012. "Some aspects of the ACA need to be fixed," she said.

Rep. Steve Cohen (D-Tenn.), who is in a relatively safe district, expressed the anxieties of many Democrats. "It puts us in a political bind: We voted for the bill, we supported the bill, we supported the president — frankly, a lot of people in the caucus don't think they're getting nearly as much support from the White House," he said.

Sen. Mary L. Landrieu (D-La.), in a tough reelection battle, picked up more Democratic sponsors of her legislative fix for the cancellation problem, and Sen. Mark Udall (D-Colo.), who is also up for reelection, announced a similar proposal Wednesday. Sen. Jeanne Shaheen (D-N.H.), who is seeking a second term, introduced a bill Wednesday that would postpone the March 31 deadline for enrollment until the website is improved.

The Obama administration has resisted pressure to make substantive changes to the law, arguing that the program is beginning to work.

"In every part of our country, Americans are very interested in the affordable health coverage that is being offered through the marketplace and through Medicaid," Health and Human Services Secretary Kathleen Sebelius said. "Even with the issues we've had, the marketplace is working and people are enrolling."

Sebelius also expressed confidence that as the healthcare.gov website is fixed, more Americans would sign up. "You don't have to pay until Dec. 15" to get coverage next year, she said. "And insurance … is very different than buying a toaster. People want to make sure their doctor is in their network. They want to see what kind of benefits they have."

White House spokesman Jay Carney said Wednesday that a fix would be coming "soon" to allow Americans to keep health plans they had purchased into next year. Carney dismissed the Republican bill as "legislation that actually causes more problems than it fixes" and emphasized that Obama would act.

Senate Majority Leader Harry Reid (D-Nev.), who spoke with Obama at length late Tuesday night, said he was "very comfortable" that the issues with the healthcare law would be solved.

One potential fix would make it easier for insurers to extend health plans beyond the end of the year. Several insurers have already taken steps to keep customers for a few more months into 2014.

Even as the White House moved to reassure nervous allies, however, administration officials offered conflicting views on whether they would meet their pledge to hit a Nov. 30 deadline for repairing the troubled website that has blocked many Americans from shopping for health coverage.

Todd Park, the administration's chief technology officer, testified at a House hearing Wednesday that he could not guarantee the White House would meet its self-imposed deadline. "The team is working incredibly hard to meet that goal," Park said when asked whether the site would be fully working by the deadline.

But at the White House, Carney said that "the site will be working smoothly for the vast majority of users by the end of the month."

The website's problems have clearly had a major impact on enrollment, the figures released Wednesday indicate. Three-quarters of the people who successfully enrolled in health coverage used state-based marketplaces rather than the troubled federal healthcare.gov site.

The federal site is the portal for residents in 36 states that have asked the federal government to operate their marketplaces.

There have been fewer problems in the marketplaces operated by the 14 states that are running their own marketplaces. Two of those states — California and New York — accounted for half of all enrollees in October.

Getting 7 million people enrolled next year is viewed as crucial to ensuring that the insurance pools have adequate numbers of healthy consumers to balance the expected influx of sick Americans who are eager to get health coverage.

Consumers have until Dec. 15 to sign up for insurance if they want to be covered on Jan. 1.

The open enrollment period under the law runs until March 31, however, giving consumers almost three more months in 2014 to select a plan and not be penalized for lacking health coverage.

Health policy experts have noted that enrollment is often slow at the start of a new government program.